At Cardiac & Vascular Care in San Jose, California, our cardiologists are highly trained to treat vascular conditions such as chronic venous insufficiency, varicose veins, spider veins, and deep vein thrombosis.
Chronic Venous Insufficiency (CVI)
Arteries carry oxygenated blood from the heart to the rest of the body, while veins carry oxygen-depleted blood back to the heart. If valves in your lower leg veins don’t work properly, you may experience a condition known as chronic venous insufficiency, or venous reflux.
These valves prevent blood from flowing backward as it is carried up the legs back to the heart. If they weaken, blood will instead begin to flow back toward the feet and pool in the veins of the lower legs, resulting in varicose veins or spider veins.
If not treated, chronic venous insufficiency can worsen over time. Learn more about these venous reflux conditions below.
An estimated 30 million women and men suffer from chronic venous insufficiency (CVI) in the US. Risk factors include standing for prolonged periods of time (increases pressure on the veins), age (elasticity of veins decreases over time), heredity (it tends to run in families), pregnancy (circulatory and hormonal changes affect the veins), and obesity (further strains already weakened valves).
As venous reflux progresses, symptoms of CVI may include:
- Achy, fatigued legs
- Itching or burning
- Restless legs
- Skin damage and discoloration
- Leg swelling
- Venous ulcers (in extreme cases)
In addition to the physical symptoms, varicose veins are visually unattractive. They typically look like bulging, twisted ropes below the skin that appear blue or purple in color.
Fortunately, early diagnosis and treatment of chronic venous insufficiency can stop the disease from progressing, and can treat these painful and aesthetically undesirable symptoms.
To diagnose varicose veins, Dr. Mehrdad Rezaee may use vascular ultrasound and mapping, which presents a clear picture of the veins and blood flow, including any vein segments that are susceptible to venous reflux. He will scan both superficial and deep veins to ensure there is no deep vein thrombosis, or blood clot that has formed in the deep veins of the legs. Symptoms of a DVT may include leg pain, swelling, redness, warmth, and large, bulging superficial veins. Risk factors include cancer, trauma, older age, recent surgery, high blood pressure, history of heart disease, pregnancy, and long periods of being immobile such as on bed rest or long flights.
Treatment for Varicose Veins
Varicose vein treatment depends on the extent of disease. Options may include conservative measures such as compression socks or medications, or minimally invasive techniques such as sclerotherapy injections or endovenous radiofrequency thermal ablation.
The goal of wearing properly fitted compression socks is to improve blood flow by preventing the pooling of blood in the legs. This simple step can help prevent cardiovascular problems for patients at risk of developing blood clots – such as those who sit or stand for long periods of time, including bed-bound patients recovering from surgery, or those who do a lot of airplane travel. Patients may also be advised to keep their legs elevated above their heart to reduce swelling and increase blood flow.
There are a wide variety of medications we may prescribe to alleviate vascular problems and symptoms. For example, blood thinners and vasodilators (which open blood vessels) are commonly used to improve blood flow.
If a damaged or leaking blood vessel needs to be removed, a minimally invasive sclerotherapy procedure may be used instead of the more traditional surgical removal. In this case, an irritant (sclerosant) is injected directly into the vessel, effectively shrinking and closing it. Sclerotherapy may be used to treat varicose veins or venous malformations that are causing cardiovascular health issues.
Endovenous radiofrequency thermal ablation is a highly effective, nonsurgical treatment that offers fast relief from painful CVI symptoms almost immediately, as well as a significantly shorter recovery period. Dr. Rezaee uses Venefit™ Targeted Endovenous Therapy, formerly known as the VNUS Closure™ procedure. This innovative procedure uses radiofrequency (RF) energy to heat the collagen in the vein walls in small segments, causing them to contract, collapse, and close. Using ultrasound guidance, Dr. Rezaee guides a catheter to the diseased vein to heat it. After the diseased vein has been sealed, the blood is rerouted to other healthy veins, and the treated veins will shrink and naturally be absorbed by the body.
Venefit is a long-term solution to vein disease, with dramatically less post-procedure discomfort and bruising than alternative vein treatments such as endovenous laser and vein stripping. Physical symptoms may resolve within hours of the procedure, while the visual appearance of varicose veins will diminish over the following weeks or months.
Since Dr. Rezaee performs the procedure in our office, there is no hospitalization or general anesthesia involved. Treatment can be completed in an hour or less and there is little to no downtime for patients. Most health insurance plans will cover the cost of the Venefit procedure for patients diagnosed with CVI.
Spider veins are similar to varicose veins but are smaller and usually do not bulge above the skin’s surface. Also known as telangiectasias or venulectasias, spider veins appear as a tangled web of red, blue, or purple blood vessels and capillaries just below the surface of the skin. They typically occur on the thighs, lower legs, and face.
Like varicose veins, spider veins may be caused by extended periods of standing, genetics, pregnancy, hormonal changes, obesity, trauma to the skin’s surface, and sun exposure.
While untreated varicose veins can progress and cause health problems, spider veins do not. They don’t cause any symptoms and do not require medical intervention. Instead, they are more of a cosmetic concern. As such, health insurance will not cover the cost of treatment, which may include sclerotherapy injections or surface laser treatment.
If you are experiencing symptoms of chronic venous insufficiency and want to know more about your treatment options, call Cardiac & Vascular Care at (408) 295-2257 or you can request an appointment online.